Diabetic Eye Screening in Singapore: How Often, What Tests, and What “Normal” Looks Like?
Being diabetic is more than just keeping a tight watch on your blood sugar. Many are unaware that uncontrolled diabetes can affect vision. The condition is known as diabetic retinopathy, in which the tiny vessels of the retina are damaged. Hence, it is essential for those living with diabetes to go for regular diabetic eye screening in Singapore to detect any early changes in the retina, as one’s vision can be affected.
This article will shed light on screening frequency, what tests are involved in screening, what “normal” really looks like, and what to do when diagnosed.
The symptoms of diabetic eye diseases can be silent in the early stages
Eye specialists have advised that diabetic retinopathy in Singapore usually starts quietly. In the initial stages, there are no symptoms, and people live their lives as per normal with no pain and no change in vision. The main reason being the damage to the tiny vessels of the retina starts small – a little swelling and small leaks usually do not affect central vision yet.
Unfortunately, when symptoms including sudden loss of vision, blurring of vision and dark patches manifest, it would also mean the condition is at a quite advanced stage.
Hence, diabetic eye screenings offered in Singapore clinics serve an important purpose – it catches an eye disease before the onset of symptoms.
What is involved in a diabetic eye screening?
For those who have never had a diabetic eye screening, it can be quite daunting for some. Hence, it would be comforting to know that the screening is painless and straightforward. A typical eye screening usually includes:
- Visual acuity test
You will be asked to read letters and numbers on a chart to determine how well you see at different distances. This test can pick up subtle vision changes. - Dilated retinal examination
The pupils are dilated with eyedrops. When the pupils have fully opened up, the eye specialist is able to assess the retina using special lenses and lights. Post-dilation, though, the vision may be blurry and sensitive to light for about 4 to 6 hours. - Retinal photo
Digital retina photos are taken to track the eye for any changes. These photos document progression, if any, over time and are an integral part of a diabetic retinopathy screening in Singapore. - Optical Coherence Tomography (OCT) Imaging
OCT is an eye scan that shows the cross-sectional images of the retina. It is able to detect swelling (macular edema) that may not be visible to the eyes during an eye examination by the eye specialist.
A diabetic eye screening in Singapore can typically take about 2 to 3 hours, as pupil dilation is involved.
“No symptoms” does not mean “no disease”
Non-Proliferative Diabetic Retinopathy (NPDR) is the earliest stage of diabetic retinopathy.
In early NPDR, the vision largely remains unaffected. Very small balloon-like protrusions (microaneurysms) form, and minute amounts of fluid or blood may leak.
This is the reason many people are taken aback when they see well but are diagnosed with early diabetic retinopathy.
In the absence of treatment, NPDR can progressively advance to more severe stages (proliferative diabetic retinopathy), and symptoms include significant bleeding, macular swelling and abnormal new blood vessel growth.
Early detection allows eye specialists in Singapore to provide timely diabetic retinopathy treatment before vision is permanently affected or, worse still, lost.
How often should you screen?
There is no one-size-fits-all answer. Screening frequency is determined by a few factors, such as your type of diabetes, the period you have had diabetes for, and how well-controlled your blood sugar is.
General recommendations:
Type 1 diabetes – To have the first screening 5 years after diagnosis. Thereafter, once a year or more as advised by your eye specialist.
Type 2 diabetes – To screen once diagnosed, as the diabetes may have already started for some years. Thereafter, once a year or more as advised by your eye specialist.
Diagnosed with diabetic retinopathy – To screen every 3 to 6 months, depending on the eye specialist’s advice and severity.
Women with diabetes – Should have an eye screening before planning to get pregnant or in early pregnancy. The eye specialist may advise additional visits during pregnancy.
Poor diabetic control
HbA1c (glycated haemoglobin) is a blood test to measure the average blood sugar (glucose) levels over the past 2 to 3 months. Having a high HbA1c level increases the risk of having diabetic retinopathy. Hence, if there is poor diabetic control, your eye specialist may advise more frequent diabetic eye screening in Singapore.
What does an eye specialist look for?
During screening, the doctor carefully examines the retina for the following warning signs:
- Microaneurysms: Tiny protrusions in weakened blood vessels – often the earliest sign of diabetic retinopathy
- Retinal haemorrhages: Small blood clots
- Hard exudates: Yellowish deposits left behind when fluid leaks from blood vessels
- Macular edema: Swelling in the central retina (macula)
- Abnormal new blood vessels: Fragile new vessels grow and may bleed into the eye (advanced stage).
The eye specialist will also check for bleeding in the vitreous (a clear, colourless, jelly-like substance between the lens and retina) if sudden floaters are seen. In most cases, floaters are harmless, but there are cases that need urgent medical attention. For those with diabetes, floaters may be a sign of retinal bleeding and must be checked promptly by an eye specialist.
What results mean: Normal vs early changes vs urgent findings
Results from a diabetic eye screening in Singapore generally fall into 3 categories:
- Normal: No signs of diabetic retinopathy. To continue a good control of blood sugar and blood pressure. Should still have regular eye screening as per your eye specialist’s advice, as diabetic eye disease can still develop at a later time.
- Early changes (Mild NPDR): Small microaneurysms or minor bleeding occurs usually not causing any vision issues yet. No immediate treatment is needed in most cases, though close follow-up is generally recommended. Watching your diet and improving your lifestyle (exercise, quitting smoking) can slow down the progression of the condition.
- Urgent or advanced findings: Proliferative diabetic retinopathy has occurred with significant bleeding and macular edema. Sudden drops or changes in vision usually take place. At this juncture, diabetic retinopathy treatment with an eye specialist in Singapore is warranted. Treatments include injections, laser therapy, or surgery.
If something is found, what happens next?
Modern diabetic retinopathy treatment provided by Singapore clinics has a high level of efficacy, especially when treatment starts timely. Therefore, there is no need to get overly worried if abnormalities are found. Depending on symptoms and severity of the condition, possible treatments include:
- Close monitoring by an eye specialist: Expect more follow-up visits every few months to track progression
- Anti-VEGF injection: This is done to decrease swelling and to halt abnormal blood vessel growth by injecting medicine into the eye
- Laser treatment: Performed to close up leaking vessels or decrease abnormal vessel growth.
- Vitrectomy surgery: Performed if there is severe bleeding or when the vision is affected by scar tissue
At the same time, your eye specialist in Singapore will work closely with your general practitioner or endocrinologist to bring your diabetes under control, as this is key to the management of diabetic retinopathy – stabilise the condition and slow down progression.
A checklist of items to bring for your eye screening visit
To help your eye specialist make a more accurate diagnosis and provide a more targeted diabetic retinopathy treatment in Singapore, please bring along:
- Most updated HbA1c results
- All the medications and supplements you are currently taking
- Previous blood pressure readings, if any
- History of previous eye treatments, if any
- Previous and current vision issues, including poor vision, distorted vision, floaters, flashes
- Sunglasses, as the eyes may be more sensitive to light post-pupil dilation
Final thoughts
Akin to cataract and glaucoma, diabetic retinopathy is one of the leading causes of blindness. At the same time, loss of vision is also one of the most preventable complications of diabetes if detected early.
It is thus imperative for those with diabetes to have routine diabetic eye screening in Singapore, as symptoms more often than not manifest in the late stage of the eye disease. Early detection coupled with timely treatment will preserve one’s vision optimally and achieve better outcomes.
If you are diabetic, act before floaters and blurred vision occur. Contact Eye Max Centre at manger@eyemax.sg or +65 6694 1000 for a diabetic eye screening to protect your vision.
